A pharmacotherapy follow-up program in patients with type-2 diabetes in community pharmacies in Spain

Abstract

Objective: Poor metabolic control and high associated morbidity and mortality among type 2 diabetic patients require a level of care from the pharmacist that goes beyond usual dispensing. The aim of the present study was to evaluate the improvement in metabolic control, the resolution of drug-related problems (DRPs) and the increase in patient awareness of diabetes as outcomes of a pharmacotherapy follow-up program in type 2 diabetic patients.

Method: Randomized controlled trial conducted in 14 community pharmacies in the province of Pontevedra (Spain) with 112 patients between February 2003 and March 2004. The control group received the usual care, and the intervention group patients were included in a pharmacotherapy follow-up program. This individualized program, which consists of the detection and resolution of DRPs and diabetes education, involves patients in their own care in order to obtain maximum benefit from the medication they use.

Main outcome measures: HbA(1c), Fasting Blood Glucose (FBG), lipid profile, blood pressure, body mass index (BMI), DRPs and knowledge were evaluated at the onset of the program and periodically until conclusion.

Results: There was a significant difference in changes from baseline between the intervention and the control group in DRPs (1.7+/-1.2 versus 3.1+/-1.2 P<0.0001), knowledge (17.9+/-3.7 versus 11.4+/-6.7 points P<0.0001), HbA(1c) (7.9+/-1.7 versus 8.5+/-1.9% P<0.0001), FBG (154+/-61.3 versus 168+/-57.8 mg/dl P=0.0004), total cholesterol (202+/-41.5 versus 217+/-43.5 mg/dl P=0.0054) and SBP (135+/-16.4 versus 150+/-19.9 mmHg P=0.0006).

Conclusions: A substantial number of patients showed an improvement in their outcomes for the chosen metabolic indicators. Pharmacotherapy follow-up programs conducted by community pharmacists can play an important role in achieving therapeutic goals in patients with type 2 diabetes. This study shows that the incorporation of type 2 diabetic patients in a pharmacotherapy follow-up program may contribute to achieve positive clinical outcomes and will contribute to the implementation and progress of pharmacotherapy follow-up programs in community pharmacies.